This post was updated Wednesday at 10 a.m. to reflect the results of Tuesday night's Senate vote.

Despite misgivings about the closed-door process used to write a bill to repeal and replace the Affordable Care Act and its potential impact on rural health care providers, Republican U.S. Sen. Jerry Moran joined his Kansas counterpart, Pat Roberts, in voting Tuesday to begin debate on the legislation.

But a short time later, Moran was one of nine GOP senators who voted against a replacement bill backed by Republican leaders.

The Kansas Hospital Association says the revised health care proposal in the U.S. Senate still comes up short of what’s needed for patients and hospitals in Kansas.

Kansas Hospital Association spokeswoman Cindy Samuelson says the revised Better Care Reconciliation Act would lead to hundreds of millions of dollars in Medicaid cuts for Kansas. Samuelson says that will reduce access to care for children, people with disabilities, and those in nursing homes.